Missouri > Federal > US Probation Office > Eastern District
Request For Monthly Cash Flow Statements Financial Records PROB 48C - Missouri
| Request For Monthly Cash Flow Statements Financial Records Form. This is a Missouri form and can be used in Eastern District US Probation Office Federal . |
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OPROB 48C Page 1 of 2 (9/00) REQUEST FOR MONTH LY C ASH FLOW ST ATEMENT FINA NCI AL RECORDS DEFEND ANT S FULL NAME DOCKET NUMBER All entries on the Cash Flow Statement must be accompanied by supporting documentation. Provide the probation officer with all records listed below that are applicable to your financial statements, along with your completed Cash Flow Statement by the close of business .MON THLY CAS H INFLOWS Allowances (housing, auto, travel) Copy of related pay stub, 1099 form for prior year, and possibly a letter fromSal ary/Wages the employer on company letterhead. Copy of all W-2 forms submitted with the prior year income tax return. Copy of Gratuit ies/Tips all pay-stubs for the most recent one-month period. Cash Advan ces Copy of current months pay-stubs, letter from employer estimating monthly gratuities earned, and W-2 form for the prior year. Copy of all pay-stubs documenting cash advances. Spouse (Significant Others) Salary/Wages Cash Bonuses Copy of all W-2 forms submitted with the prior year income tax return. Copy of all pay-stubs for the most recent one-month period. Copy of all pay-stubs documenting cash bonuses, and copy of related 1099 form. Other J oint Spousal Income Com missions Documentation verifying any monthly income jointly earned with the spouse Copy of all 1099 forms submitted with the prior year income tax return.or significant other, (e.g., income from the spouse or significant other or income from a business owned or controlled by the spouse or significant other,Business Income that the defendant has a joint ownership interest in, or controls). Copy of the past six monthly financial statements of all businesses owned orIncome of Others in the Home controlled by the defendant. Also be sure to provide all financial information Verification of the monthly earnings of all others living in the defendants requested in the Assets portion of the Net Worth Statement under Sectionhousehold (e.g., all pay-stubs for the prior month, W-2 forms, and 1099 K, Business Holdings. forms for the prior year), paid receipts or canceled checks for necessary monthly household expenditures (e.g., for food, room rental, telephone,Interest/Dividends transportation, etc.) actually paid by this person on behalf of the defendant. Copy of most recent earnings statement from a financial institution (e.g., bank,Gifts Fr om Family brokerage firm, etc.). Copy of all 1099-INT forms, reporting annual interest earnings, for the past year. A signed and dated statement from the family member who gave gifts to the defendant during the month, listing the amounts, dates and reasons given, andRental Income a copy of the check received, if any. Copy of lease rental agreement, copy of monthly rental check received, and copyGifts From Others of the deposit on the defendants monthly bank statement. A signed and dated statement from the person(s) who gave gifts to theTru st Income defendant during the month, listing the amounts, dates and reasons given, and a copy of the check received, if any. Copy of the monthly trust income check, copy of the trust agreement, and a copy of the trust income tax return for the prior year. Loans Fr om Your Business Copy of the past six monthly financial statements of all businesses owned orAlimony/Child Support controlled by the defendant that loaned money to the defendant, including a detailed schedule of the Loans To Shareholder/Owner or Due From Copy of divorce decree, copy of payments received, and statements documentingShareholder/Owner general ledger accounts. child support/alimony obligations with payment history. M ortgage Loans Social Security Copy of all mortgage checks received during the prior month, 1099 forms Copy of most recent Social Security check and most recent benefits determinationsubmitted with the prior year tax return, and copy of the sales agreement and letter. escrow statement for all mortgage loans owed to the defendant.Other Governm ent Benefits Other Loans Copy of most recent government subsidy check (e.g., unemployment Copy of loan documentation and copy of all loan checks received during the compensation, or child support/alimony) and most recent benefits determinationprior month. letter. Other (specify) Pensions/Annuities Documentation verifying the source of all other monthly cash inflows (not yet disclosed or reported in these financial statements) and copy of all related Copy of pension/annuity check, copy of most recent pension plan activitymonthly checks received. statement or annuity statement, and copy of pension plan or annuity contract. <<<<<<<<<********>>>>>>>>>>>>> 2OPROB 48C Page 2 of 2 (9/00) RE QUEST FOR M ONTH LY CA SH FL OW STA TE M EN T F INA NC IAL RE CO RD S (cont.) NECESS ARY MONTHLY CASH OUTFLOWS Cr edit Car d Payments Rent or M ortgage (including taxes) Copy of most current billing statement for all charge accounts (e.g., credit cards, revolving charge cards, and department store cards) and lines of credit (e.g., Copy of apartment rental lease agreement or home mortgage, most recentbank line of credit). mortgage statement, and copy of canceled check. M edical Groceries (# of people) Documentation of medical expenses (e.g., billing statements, payment receipts Grocery receipts with corresponding canceled checks and canceled checks). (if applicable) for the past month. Alimony/Child Support Utilities Copy of divorce decree, canceled checks, and statements documenting child Copy of most current utility bills (e.g., electric, heating oil/gas, water/sewer,support/alimony obligations with payment history. telephone, and basic cable). Co-payments (electronic monitoring, drug/mental health treatment)Trans port ation Canceled check along with statement from the service provider (if any). Current month gasoline/motor oil receipts and corresponding canceled checks (if applicable), and gasoline credit card statements for the prior month.Oth er (specify) Insura nce Specific receipts, billing statements, and corresponding canceled checks. Copy of most current insurance bills for all types of insurance (auto, health, life, homeowners). Clothing Purchase receipts with corresponding canceled checks. Lo an Payments Copy of loan statements (including motor vehicle payment book and lines of credit) for all loans. Also provide a copy of any financial statements submitted to obtain credit in the past three years. ADDITIONAL INSTRUCTIONS: A personal interview has been scheduled for you with: on U.S. Probation Officer Date
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